NPIMap

Organization Active NPI

Bethany Christian Services, Inc

  • Community/Behavioral Health Agency
  • Holland, MI
National Provider Identifier
1629134341
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
6801019086 CSW Issued in MI
Legal business name
BETHANY CHRISTIAN SERVICES, INC
Practice address
12048 James St
Holland, MI 49424-9661
Phone
(616) 396-0623
Fax
(616) 396-2315
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Steve Eckert, MSW
Title
Director
Phone
(616) 396-0623

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6801019086 CSW MI Primary

Addresses

Primary practice location

12048 James St
Holland, MI 49424-9661

Mailing address

12048 James St
Holland, MI 49424-9661
Phone (616) 396-0623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040913000022 MI Part B Supplier - Clinic/Group Practice 2567439342 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Grand Haven, MI; Grand Rapdis, MI; Holland, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bethany Christian Services18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

1475 Robbins Rd
Ste 120
Grand Haven, MI 49417
Phone (616) 844-0690

12048 James St
Holland, MI 49424
Phone (616) 396-0623

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1629134341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12048 JAMES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494249661",
            "telephone_number": "616-396-0623",
            "fax_number": "616-396-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12048 JAMES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494249661",
            "telephone_number": "616-396-0623",
            "fax_number": "616-396-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY CHRISTIAN SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "ECKERT",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "616-396-0623",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6801019086 CSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.